my son is 20 months. on the day of his birth, an intern told my husband he heard a heart murmur, but the resident later said there was no murmur, and no doctor has ever mentioned it. as a longtime sufferer of health anxiety, i've waited for a heart problem to emerge.
a week ago, my son began vomiting, which lasted about 12 hours, during which time he developed a fever and then diarrhea. mild diarrhea continues, and occasionally it seems his stomach is bothering him and he comes to me and wants to be held with his head on my shoulder. 3 days ago, after the fever had broken, he erupted in hives. since then they have come and gone--returning in different parts of his body (legs, arms, and face). he seems almost back to normal other than the unsightly rash--his appetite is finally back and his energy level is improving. last night he had a horrible outbreak of hives on his feet and i noticed his big toenail looked purplish, on one foot in particular. i didn't think much of it. today, about 10 minutes after a fairly intense tantrum, he asked to be picked up and lay his head on my shoulder for a few minutes quietly (normally this would be bizarre behavior from him, but as i mentioned he's been doing this since he's been sick). during this time, my husband noted that his lips were dusky/purplish--it was slight but noticeable to both of us. i put him back in the stroller and he was cheerful, talking, etc. i didn't notice any breathing abnormalities but forgot to check his nail beds. my husband pulled his lip down and said his gums were pink, but by that point his lips were going back to normal color anyway. the entire thing was over in less than 5 minutes. he had just finished drinking an icy smoothie, but it was a warm day. shortly after this the hives on his face, arms, and legs cleared, and so far they haven't returned. I'm totally freaked out that something is wrong with his heart. is it possible to have TOF that hasn't presented yet?
At this point in his life, it would not be possible for tetralogy of Fallot (ToF) to appear with the minimal findings that he is exhibiting. I cannot say for sure without seeing him, but it sounds as if his brief perioral cyanosis is typical for what we call vasomotor instability,which is common in infants and toddlers. It is benign and spontaneously resolves.
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